The Role of Magnesium Sulphate in Treatment of Subarachnoid Hemorrhage and its Effect on Outcome

[摘要] Background: High-dose magnesium sulphate (MgSO4) therapy is safe and reduces the incidence of delayed ischemic neurological deficit (DIND) and subsequent poor outcome after subarachnoid hemorrhage (SAH). Objective: The aim of the study was to assess the safety and efficacy of high-dose MgSO4 therapy after SAH in order to reduce incidence of DIND and to evaluate the impact on clinical outcome. Methods: The study was carried out on 20 patients with SAH in neurology critical care unit, Zagazig University Hospitals, from January 2007 to July 2010.  Our 20 patients were divided into eight patients who received placebo and 12 patients who received MgSO4.Magnesium sulphate (MgSO4) infusion was adjusted every 12 hours until day 10 according to the target serum magnesium level. The occurrence of DIND, secondary infarction, side effects, and the outcome after 3 and 12 months were assessed. Results: The difference in occurrence of DIND and secondary infarction was not significant. Treatment group showed a significantly better outcome after 3 months and after 1 year. Hypotension and hypocalcemia occurred more in the treatment group than placebo group but the difference was not statistically significant. In 42% of patients, the MgSO4 therapy had to be stopped before day 10 because of side effects. Conclusion: High-dose MgSO4 therapy might be effective as a prophylactic therapy after SAH to reduce the risk for poor outcome. However, because of the high frequency of the side effects, patients should be observed in an intensive care unit. [Egypt J Neurol Psychiat Neurosurg.  2011; 48(1): 79-83]

[学科分类] 精神健康和精神病学